Currently there are widespread shortages of suitably qualified obstetricians and gynaecologists who can safely undertake the role of senior resident doctor out of hours with indirect supervision from a consultant who is non-resident.
Where possible, healthcare providers encourage the use of internal locums, however this is not always possible and external locum doctors are sometimes required.
These locum doctors have not always worked in the unit. Therefore appropriately robust recruitment processes and assessment of their skills and knowledge (with structured feedback and support) are required before they are released to work independently. This is to ensure that there is no compromise in patient safety and quality of care.
Our goals are:
- To improve support for locum doctors in maternity
- To support employers in safely covering gaps in rotas
- To support permanent staff when they are covering gaps
In this guidance a long-term locum is one where a placement is greater than 2 weeks in duration. This guidance recommends employing organisations offer locums support and supervision including:
- Departmental induction by a consultant on commencement date
- A named consultant supervisor
- Supernumerary clinical duties undertaken with direct supervision prior to commencing OOH duties
- Review of suitability for post and OOH working based on MDT feedback
This guidance includes advice on:
- Measures to avoid acting down
- Covering difficult to recruit to posts
- Managing short notice absence
- Considerations when asking a doctor to act down
- Procedures for requesting a consultant or SAS to act down
- Remuneration and compensation for acting down
There is an increasing need and expectation for consultants to attend overnight whilst non-resident on-call due to increased patient numbers and the rising complexity of cases. RCOG have produced updated guidance on appropriate standards for compensatory rest for consultants and senior SAS doctors following non-resident on call activity.
- Attendance and telephone advice from on call senior clinicians has increased.
- Compensatory rest for consultants should be actively supported and facilitated by the management team.
- It is recommended that the decision to take rest is not left to the individual consultant but agreed via constructive discussion between the manager/clinical director and clinician.
- Job planning should factor in these recommendations for compensatory rest.
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